The evidence supports a valid association of a limited number of dietary factors and dietary patterns with CHD. Future evaluation of dietary patterns, including their nutrient and food components, in cohort studies and randomized trials is recommended.

Canadians are living longer, and older persons are making up a larger share of the population (14% in 2006, projected to rise to 20% by 2021). The Canadian Longitudinal Study on Aging (CLSA) is a national longitudinal study of adult development and aging that will recruit 50,000 Canadians aged 45 to 85 years of age and follow them for at least 20 years. All participants will provide a common set of information concerning many aspects of health and aging, and 30,000 will undergo an additional in-depth examination coupled with the donation of biological specimens (blood and urine). The CLSA will become a rich data source for the study of the complex interrelationship among the biological, physical, psychosocial, and societal factors that affect healthy aging.

To examine factors influencing readiness for healthcare organizational change, 654 randomly selected hospital staff completed questionnaires measuring the logistical and occupational risks of change, ability to cope with change and to solve jobrelated problems, social support, measures of Karasek's (1979) active vs. passive job construct (job demand× decision latitude) and readiness for organizational change. Workers in active jobs (Karasek, 1979) which afforded higher decision latitude and control over challenging tasks reported a higher readiness for organizational change scores. Workers with an active approach to job problem‐solving with higher job change self‐efficacy scores reported a higher readiness for change. In hierarchical regression analyses, active jobs, an active job problem‐solving style and job‐change self‐efficacy contributed independently to the prediction of readiness for organizational change. Time 1 readiness for organizational change scores and an active approach to job problem‐solving were the best predictors of participation in redesign activities during a year‐long re‐engineering programme.

, MBBS, DPhil, FRCP(c); for the SHARE Investigators Background-Body mass index (BMI) is widely used to assess risk for cardiovascular disease and type 2 diabetes. Cut points for the classification of obesity (BMI Ͼ30 kg/m 2 ) have been developed and validated among people of European descent. It is unknown whether these cut points are appropriate for non-European populations. We assessed the metabolic risk associated with BMI among South Asians, Chinese, Aboriginals, and Europeans. Methods and Results-We randomly sampled 1078 subjects from 4 ethnic groups (289 South Asians, 281 Chinese, 207Aboriginals, and 301 Europeans) from 4 regions in Canada. Principal components factor analysis was used to derive underlying latent or "hidden" factors associated with 14 clinical and biochemical cardiometabolic markers. Ethnicspecific BMI cut points were derived for 3 cardiometabolic factors. Three primary latent factors emerged that accounted for 56% of the variation in markers of glucose metabolism, lipid metabolism, and blood pressure. For a given BMI, elevated levels of glucose-and lipid-related factors were more likely to be present in South Asians, Chinese, and Aboriginals compared with Europeans, and elevated levels of the blood pressure-related factor were more likely to be present among Chinese compared with Europeans. The cut point to define obesity, as defined by distribution of glucose and lipid factors, is lower by Ϸ6 kg/m 2 among non-European groups compared with Europeans. Conclusions-Revisions may be warranted for BMI cut points to define obesity among South Asians, Chinese, and Aboriginals. Using these revised cut points would greatly increase the estimated burden of obesity-related metabolic disorders among non-European populations.

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EW ISSUES IN THE FIELD OF FAM-ily violence generate as much controversy as screening women for intimate partner violence (IPV) in health care settings. 1,2 Herein, we use the term screening to refer to universal routine inquiry: "a standardized assessment of patients, regardless of their reasons for seeking medical attention," 1 aimed at identifying women who are experiencing or have recently experienced IPV.Proponents of screening emphasize the following as a rationale for its implementation: the high prevalence of IPV and associated impairment, 3,4 the high level of acceptability among women about such inquiry, 5,6 the availability of feasible screening techniques, 7,8 and the opportunity to offer support and refer-rals to patients once IPV is identified. 6,9 Organizations such as the US Preventive Services Task Force 10 and the Canadian Task Force on Preventive Health Care 11 have concluded that insufficient evidence exists to recom-For editorial comment see p 568.

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